【摘要】 目的 探讨糖尿病前期及T2DM患者左室舒张功能的改变情况。 方法 通过彩色血流多普勒、组织多普勒(DTI)及生化指标N末端B型钠尿肽前体(NT-proBNP)分别对IGT组、IFG组、T2DM组及正常对照(NC)组进行观察对照。主要检测指标包括舒张早期二尖瓣血流峰值速度(E值)、舒张晚期血流峰值速度(A值)、E/A值、二尖瓣环左侧壁附着处心肌舒张早期运动峰值速度(Em)、舒张晚期运动峰值速度(Am)、Em/Am值、E/Em值及NT-proBNP生化值。结果 E值、A值、E/A值、Am值在NC组、IGT组、IFG组间差异均无统计学意义(P>0.05)，T2DM组与以上各组间差异均有统计学意义(P<0.05)，Em、Em/Am、E/Em值在4组间两两比较除IGT组与IFG组间外，差异均有统计学意义(P<0.05)。NT-proBNP值在NC组、IGT组、IFG组间差异无统计学意义(P>0.05)，T2DM组与以上各组间差异均有统计学意义(P<0.05)。E/Em值与NT-proBNP值之间具有良好相关性(r=0.827，P<0.01)。组织多普勒对舒张功能异常检出率比传统多普勒高(χ2=8.1，P<0.01)。 结论 IGT、IFG及T2DM患者均存在心脏舒张功能受损，组织多普勒对舒张功能检测比传统彩色血流多普勒更敏感，NT-proBNP可作为舒张性心功能不全早期诊断的可靠指标。

　　【关键词】 糖耐量异常;空腹血糖受损;糖尿病，2型;组织多普勒;N末端B型钠尿肽前体;心脏舒张功能

　　Evaluation on the left ventricular diastolic function in patients with abnormal glucose metabolism in the early stage GAO Song, WEI Chun-ying, WEN Yuan, et al. Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330000, China

　　Corresponding author: WEI Chun-ying

　　【Abstract】 Objectives To explore the changes of left ventricular (LV) diastolic function in pre-diabetes and T2DM patients. Methods The subjects were classified into the impaired glucose tolerance (IGT) group, the impaired fasting glucose (IFG) group, type 2 diabetes mellitus (T2DM) group, and normal control (NC) group. The LV diastolic function was assessed by color Doppler flow imaging, Tissue Doppler Imaging (TDI), and NT-proBNP. The corresponding indices include early diastolic mitral flow velocity (E), late diastolic mitral flow velocity (A), E/A ratio, the peak early diastolic mitral annular velocity (Em), the peak late diastolic mitral annular velocity (Am), Em/Am ratio, and E/Em ratio. Results There were no significant differences in the levels of E, A, E/A ratio, and Am among the NC group, IGT group, and IFG group (P>0.05), while those of the T2DM group were significantly different from the above three groups (P<0.05), the Em, Em/Am and E/Em ratios were significantly different in the two-two comparison ​​among the four groups except the IFG and IGT groups (P<0.05). The NT-proBNP values were not statistically different ​​among the NC group, IGT group, and IFG group (P>0.05), but that of the T2DM group was significantly different from these three groups (P<0.05). The E/Em ratio was significantly correlated with the NT-proBNP levels (r=0.827, P<0.01). DTI detection rate of diastolic dysfunction was higher than that of color Doppler flow imaging (χ2=8.1, P<0.01). Conclusion Diastolic dysfunction exists in IGT, IFG, and T2DM patients. DTI is more sensitive than conventional color Doppler flow imaging in detection rate of diastolic dysfunction. NT-proBNP can be used as a reliable index of early diagnosis of diastolic dysfunction.

　　【Key words】 Impaired glucose tolerance (IGT); Impaired fasting glucose (IFG); Diabetes mellitus, type 2; Doppler tissue imaging (DTI); NT-proBNP; Diastolic function